A Critical Review of Hank Wilson’s Bibliography of Anti-Popper Research
By Lisa Ringold, PhD pharmacology
The articles referenced in Wilson’s bibliography of research do not support his claim that nitrite use causes risky sexual behavior and a decrease in immune function that may lead to HIV infection or Kaposi's sarcoma. An important problem is that out of 90 references, 13 are listed twice and one is listed three times. This is an obvious attempt to make the body of evidence appear larger. The list contains typographical errors, an indication of a lack of attention to detail, which is an essential component of scientific evaluation. Some of his references are merely data presented at meetings as posters or informal talks, which are preliminary data that has not been confirmed or published. Finally, one of the references was submitted, but not accepted for publication. Articles that have been rejected for publication are never cited in credible reference lists.
The primary issue concerning the articles referenced by Wilson is that they are very weak in terms of data presented. The results are not repeated by other scientists. In fact, there are contradictory results both by the same researcher and between different researchers.
A major weakness of the report by Wilson is that for the immune function research (an important part of his claims), nearly every reference is work performed by Soderberg. When one investigator is primarily the only one cited, it indicates that his work has not been replicated by others. This is extremely important to establish validity of claims and the fact that other researchers are not cited is very suspect. If experimental results have not been replicated and thus confirmed by another researcher, the results are most likely not valid.
A limitation of Soderberg's work is that minimal data is presented in each of his papers and the same work is presented in more than one publication. Occasionally researchers will do this to increase their publication volume and it does not reflect that a large amount of data has been generated. In many of Soderberg’s articles, Hank Wilson is acknowledged for providing the nitrites, which indicates bias. It appears that Wilson and Soderberg are associates and considering Wilson’s zeal against nitrites, the research by Soderberg is very suspect. Hank Wilson formed the one man Committee to Monitor Poppers. Wilson's has publicly stated that his boyfriend, who always used poppers with sex and had KS, died of AIDS. Wilson has also publicly acknowledged that he himself was diagnosed with AIDS in 1987. Therefore, it is likely that Wilson has a personal vendetta against nitrites.
Another very important discrepancy is that Soderberg does not obtain consistent results between research summarized in his own papers. The fact that he publishes conflicting data without explanations for this illustrates his inability to establish a connection between nitrite use and AIDS and KS. Furthermore, Soderberg’s results are not consistent with other researcher’s results. This makes it impossible to draw any conclusions from the research that is presented. Wilson has not carefully read the references he is using to support his claims or he would not use them.
In addition to these issues, another extremely serious problem in Wilson’s articles is that the mice or rats used in the experiments are given massive doses that are not relative to a typical human exposure. In fact, in some of the studies, the doses used are lethal. Adjusting a drug dose for a particular body weight is a fundamental pharmacological paradigm for treating experimental animals and it is impossible to determine the effects of nitrites when a toxic dose is used. Therefore, the animal studies are meaningless when comparing them to humans. It is not clear how these articles were published with this blatant oversight. Furthermore, the excessive doses could explain the discrepancies in the results.
Yet another criticism of the immune function research is that the alterations in immune function were reversible. Therefore, it is likely that there are no long-term effects of nitrites, particularly considering the exceedingly high doses used. Lower doses may not have any effect on immune function.
The references cited by Wilson have a scarcity of studies utilizing human subjects. More human studies would dramatically enhance Wilson's argument and they could easily be performed. Perhaps these types of studies have been done, with no negative results, and thus have not been published.
One of the most serious problems with the behavioral studies is that they cannot establish a causal relationship between nitrite use and HIV infection. Only associations between the two can be shown, and because two behaviors occur together, this does not mean that one causes the other. The most logical explanation for the association between nitrite use and unsafe sex is that it results from an underlying personality characteristic that predisposes some men to risky behaviors, and that sexual risk-taking and substance use are just two such behaviors observed in men with risk-taking behavior. Furthermore, nitrites are readily available in places of higher risk behavior, such as pornographic theaters and bookstores.
It is also likely that the immune status of those who use drugs may already be compromised as a result of an unhealthy lifestyle or other psychological factors. To further complicate the issue most of the men who abuse nitrites also use other substances. Therefore, it is impossible to determine the effect of each substance separately. It is of particular consequence if injected drugs are used in conjunction with nitrites. The sharing of needles is a well-established route of HIV infection.
Finally, Wilson’s cited behavioral studies are derived from self-reports, which is subject to recall bias. The validity of the research relies on the accuracy of the reporter and if they are using drugs or alcohol, they may not remember specific drug use or have an altered perception of their actions.
Although Wilson proposes that nitrite use can facilitate HIV infection and Kaposi’s sarcoma, one of his references listed three articles for and three against association of nitrite use with HIV seropositivity and KS. When conflicting data is presented, one cannot conclude that nitrite use is involved in these illnesses.
Therefore, even though Wilson’s reference list might look impressive to the untrained eye, he does not have a case for his claim that nitrite use causes HIV infection or Kaposi’s sarcaoma.